The effect of restorative material and application timing on the bond strength to primary dentin treated with silver diamine fluoride

Background: This in vitro study evaluated the effects of restorative material, specifically resin-modified glass ionomer cement (RMGIC; Fuji II LC, GC Corporation, Japan) compared to bulk-fill flowable composite resin (SDR Plus, Dentsply Sirona, Germany), and the timing of their application timing on the bond strength to artificially demineralized primary dentin treated with 38% silver diamine fluoride (SDF; Riva Star, SDI, Australia). Methods: Sixty-eight extracted primary molars with artificially demineralized, flat dentin surfaces were randomly assigned to four groups (n = 17/group) according to restorative material and timing of application: GIC0 (RMGIC—day 0), BF0 (bulk-fill composite—day 0), GIC14 (RMGIC—day 14), and BF14 (bulk-fill composite—day 14). For bulk-fill restorations, a universal adhesive system was applied according to the manufacturer’s instructions. Following the SDF application and restoration procedures, all specimens were stored in artificial saliva for 30 days before testing. Macro-shear bond strength (SBS) was measured, fracture types were classified under a stereomicroscope, and selected specimens were further analyzed using scanning electron microscopy (SEM). Results: Application timing significantly influenced bond strength, whereas restorative material type showed no significant effect. Restorations placed 14 days after SDF application demonstrated significantly higher bond strength than those placed on day 0 for both RMGIC (p = 0.009) and bulk-fill composite (p = 0.011). The highest mean bond strength was observed in BF14 (5.56 ± 3.54 MPa; bulk-fill composite—day 14), while the lowest was in GIC0 (1.78 ± 1.46 MPa; RMGIC—day 0). Although bulk-fill composite demonstrated higher mean values than RMGIC within the same application time, the difference was not statistically significant (p > 0.05). Conclusions: Bond strength improved when restoration was delayed by two weeks after SDF application. Although the restorative material type did not significantly affect bond strength, application timing should be considered to optimize clinical outcomes.

Silver diamine fluoride; Bond strength; Shear bond strength; Resin-modified glass ionomer; Bulk-fill composite

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